AboutDr Alan Galbraith Expertise I can answer most questions on most drugs. Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Author of "Fundamentals of Pharmacology" 5th Edition published in November 2007 by Pearson Education, Australia.
Question Dear Doctor,
Thank you for choosing to be an expert at this site. My Q is about useful treatments of severe chronic constipation, retained flatulence and frequent impaction for my mom, 81 YO, with Lewy Body Dementia and Parkinson's. She no longer walks, but does get out of bed daily and caregivers provide limited passive exercises. History of slow colon transit time. Over past years, we have gone through treatment protocols with stool softeners, lactulose, fiber, etc. Current regimen of Miralax 17 gm 3 X/day, stool softener 2X/day, daily fiber (U.S. brand Citrucel), excellent hydration still result in constipation and impaction. We now resort to at least weekly tap-water enemas. Because my mom lives and I work at a senior care center, we are able to verify impaction with X-ray and can then treat quickly. She's had a thorough work-up, showing no mechanical or physiological obstructions. MDs say this is an effect of decreased mobility, age and progressing disease. They do not think lubriprostone (sp?) - rather new in U.S. - would be appropriate given the LBD. Her other meds are: Razadyne 8 mg bid; aspirin 81 mg 1X/day; Provigil 200 mg 1X/day; OTC multivitamin; and Seroquel 25 mg at bed.
I accept the diagnoses, and my layperson's literature search doesn't reveal much else new except the lubriprostone and some reasearch stating certain probiotics may speed transit time. I just want all the info possible to help mom, who is totally exhausted from both the constipation/impaction and the enemas. The whole cycle leads to extreme fatigue and lack of appetite, and if we don't catch it quickly enough, to pain and delirium.
Thank you again for recommendations and considerations.
Lin
Answer Dear Lin
I do not know much about this drug as it is not available in Australia. However, I have studied the literature and prescribing information on it and can find no reason why it should not be tried on your mother. Everything else has been tried and in my opinion, lubriprostone should be given a trial to make your mother more comfortable and help avoid the undue stress to which she is subject to.
